FALSE000163297000016329702024-11-122024-11-12

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
 
FORM 8-K
 
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
Date of Report (Date of Earliest Event Reported): November 12, 2024
 
American Healthcare REIT, Inc.
(Exact name of registrant as specified in its charter)
 
Maryland 
001-41951
 47-2887436
(State or other jurisdiction
of incorporation)
 (Commission
File Number)
 (I.R.S. Employer
Identification No.)
18191 Von Karman Avenue, Suite 300
Irvine, California
 92612
(Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code: (949) 270-9200
Not Applicable
(Former name or former address, if changed since last report)
 
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.01 par value per shareAHRNew York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

                                        Emerging growth company  

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.    ☐ 



Item 2.02 Results of Operations and Financial Condition.
On November 12, 2024, we issued an earnings release announcing our financial position as of September 30, 2024 and our results for the quarter then ended. A copy of the earnings release is attached hereto as Exhibit 99.1 to this Current Report on Form 8-K and is incorporated by reference herein.
Item 7.01 Regulation FD Disclosure.
On November 12, 2024, we released certain supplemental data for the quarter ended September 30, 2024. A copy of the supplemental data is attached hereto as Exhibit 99.2 to this Current Report on Form 8-K and is incorporated by reference herein.
The information contained in Items 2.02 and 7.01 hereof, including Exhibits 99.1 and 99.2 and incorporated by reference herein, is being “furnished” and shall not be deemed “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of that section, nor shall such information be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, except as shall be expressly set forth by the specific reference in such filing.
Item 9.01 Financial Statements and Exhibits.
(d) Exhibits.
Exhibit No. Description
   
104Cover Page Interactive Data File (embedded within the Inline XBRL document)




SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
 
American Healthcare REIT, Inc.
November 12, 2024
        By: /s/ Danny Prosky                     
        Name: Danny Prosky
        Title: Chief Executive Officer and President

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EXHIBIT 99.1


Press Release
Irvine, CA – November 12, 2024
Contact: Alan Peterson
Email: investorrelations@ahcreit.com
American Healthcare REIT (“AHR”) Announces Third Quarter 2024 Results;
Increases Full Year 2024 Guidance
American Healthcare REIT, Inc. (the “Company,” “we,” “our,” “management,” or “us”) (NYSE: AHR) announced today its third quarter 2024 results and updated its full year 2024 guidance, which includes the impact of the Company's recent acquisition to become the sole owner of Trilogy (as defined below).
Key Highlights:
Reported GAAP net loss of $(3.1) million and GAAP net loss attributable to common stockholders of $(0.03) per diluted share for the three months ended September 30, 2024.
Reported Normalized Funds from Operations attributable to common stockholders (“NFFO”) of $0.36 per diluted share for the three months ended September 30, 2024.
Achieved total portfolio Same-Store Net Operating Income (“NOI”) growth of 17.0% for the three months ended September 30, 2024 compared to the same period in 2023, highlighted by 61.8% and 22.6% Same-Store NOI growth from its senior housing operating properties (“SHOP”) and integrated senior health campuses (“ISHC”), respectively.
The Company is increasing total portfolio Same-Store NOI growth guidance from a range of 12.0% to 14.0% to a revised range of 15.0% to 17.0%, for the year ending December 31, 2024.
Acquired a senior housing portfolio in Washington for a total consideration of approximately $36.2 million of assumed debt, plus closing costs. The portfolio is now managed by two of the Company's existing SHOP operators.
Completed a follow-on equity offering for approximately 20.0 million shares of its common stock, raising gross proceeds of approximately $471.2 million.
Acquired its joint venture partner's remaining 24% minority membership interest in Trilogy REIT Holdings ("Trilogy Holdings") and became Trilogy's sole owner for a consideration of approximately $258.0 million of cash, which included the pre-negotiated "base" purchase price of $247 million and the approximate $11 million pro-rata distributions owed to the Company's joint venture partner.
The Company is increasing NFFO guidance from a range of $1.23 to $1.27 to a revised range of $1.40 to $1.43 for the year ending December 31, 2024, to reflect improved portfolio performance expectations, the Company's recent transaction activity and its capital markets activity.
Reported a 0.8x improvement in the Company's Net-Debt-to-Annualized Adjusted EBITDA from 5.9x as of June 30, 2024, to 5.1x as of September 30, 2024.
“We are excited to have completed our follow-on offering and the acquisition of the remaining minority membership interest in Trilogy Holdings,” said Danny Prosky, the Company’s President and Chief Executive Officer. "As the sole owner of Trilogy, we expect to continue to expand our ISHC segment while providing high-quality healthcare to the communities Trilogy's campuses serve. Beyond Trilogy, we aim to pursue external growth within our SHOP segment alongside our existing regional operators, which is where we currently see the best risk-adjusted returns in healthcare real estate."
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Third Quarter and Year-to-date 2024 Results
The Company’s Same-Store NOI growth results are detailed below. Higher occupancy, improving RevPOR, and expense management continue to support bottom-line performance.
Quarter Ended September 30, 2024 Relative to Quarter Ended September 30, 2023
SegmentNOI Growth
ISHC22.6%
Outpatient Medical0.1%
SHOP61.8%
Triple-Net Leased Properties3.0%
Total Portfolio17.0%
Nine Months Ended September 30, 2024 Relative to Nine Months Ended September 30, 2023
SegmentNOI Growth
ISHC22.2%
Outpatient Medical0.2%
SHOP48.0%
Triple-Net Leased Properties3.4%
Total Portfolio15.9%
“Property performance across our ISHC and SHOP segments remains strong. Occupancy continues to climb higher, and we have begun to realize mid-single-digit Same-Store RevPOR growth within our SHOP segment. Along with Trilogy, we will explore opportunities that will bolster our operating capabilities,” said Gabe Willhite, the Company’s Chief Operating Officer.
Full Year 2024 Guidance
The Company’s guidance for the year ending December 31, 2024, is being increased to reflect the impact of the acquisition of the minority membership interest in Trilogy Holdings and management's improved outlook on portfolio performance. Revised guidance ranges are detailed below:
Revised Full Year 2024 GuidancePrior Full Year 2024 Guidance
MetricMidpointFY 2024 RangeFY 2024 Range
NAREIT FFO per share$1.30$1.28 to $1.31$1.17 to $1.22
NFFO per share$1.42$1.40 to $1.43$1.23 to $1.27
Total Portfolio SS NOI Growth16.0%15.0% to 17.0%12.0% to 14.0%
Segment-Level SS NOI
Growth / (Decline):
ISHC22.0%21.0% to 23.0%18.0% to 20.0%
Outpatient Medical(0.3)%(0.5)% to 0.0%(0.5)% to 0.0%
SHOP52.5%51.5% to 53.5%45.0% to 50.0%
Triple-Net Leased Properties3.0%2.0% to 4.0%1.0% to 3.0%


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____________
Certain of the assumptions underlying the Company’s 2024 guidance can be found within the Non-GAAP reconciliations in this earnings release and in the appendix of the Company’s Third Quarter 2024 Supplemental Financial Information (“Supplemental”). A reconciliation of net income (loss) calculated in accordance with GAAP to NAREIT FFO and NFFO can be found within the Non-GAAP reconciliations in this earnings release. Non-GAAP financial measures and other terms, as used in this earnings release, are also defined and further explained in the Supplemental. The Company is unable to provide without reasonable effort guidance for the most comparable GAAP financial measures of total revenues and property operating and maintenance expenses. Additionally, a reconciliation of the forward-looking Non-GAAP financial measures of Same-Store NOI growth to the comparable GAAP financial measures cannot be provided without unreasonable effort because the Company is unable to reasonably predict certain items contained in the GAAP measures, including non-recurring and infrequent items that are not indicative of the Company’s ongoing operations. Such items include, but are not limited to, impairment on depreciated real estate assets, net gain or loss on sale of real estate assets, stock-based compensation, casualty loss, non-Same-Store revenues and non-Same-Store operating expenses. These items are uncertain, depend on various factors and could have a material impact on the Company’s GAAP results for the guidance period.

Transactional Activity
As previously announced, on September 3, 2024, the Company acquired a senior housing portfolio in Washington consisting of 242 units across five properties. The total consideration consisted of approximately $36.2 million of assumed debt, plus closing costs, reflecting a price per unit of approximately $149,500. The assumed debt has a fixed interest rate of 4.54% per year and matures on January 1, 2028. Portfolio operations have been transitioned to Cogir Senior Living and Compass Senior Living, two of the Company's existing regional operators in a RIDEA structure.
Additionally, as previously announced, on September 20, 2024, the Company acquired a 24% minority membership interest in Trilogy Holdings, becoming the sole owner of Trilogy. The Company acquired the interest for an all-cash purchase price of approximately $258 million, which included the pre-negotiated "base" purchase price of $247 million and the approximate $11 million pro-rata distributions owed to the Company's joint venture partner.
Subsequent to quarter end, on October 1, 2024, the Company acquired a SHOP asset located in the Atlanta MSA consisting of 90 units for approximately $7.5 million, reflecting a price per unit of approximately $83,750. Operations at the property have been transitioned to Senior Solutions Management Group, one of the Company's existing regional operators in a RIDEA structure.
Subsequent to quarter end, on October 16, 2024, the Company also sold one Outpatient Medical building for approximately $19.4 million. As of November 12, 2024, the Company has sold approximately $35.0 million of Non-Core Properties year-to-date.
Capital Markets and Balance Sheet Activity
As of September 30, 2024, the Company’s total indebtedness was $1.90 billion, and it had approximately $1.07 billion of total liquidity, comprised of cash, restricted cash and undrawn capacity on its lines of credit. The Company's Net-Debt-to-Annualized Adjusted EBITDA as of September 30, 2024, was 5.1x.
As previously announced, on September 20, 2024, the Company completed an offering for approximately 20.0 million shares of its common stock, raising gross proceeds of approximately $471.2 million. Net proceeds were used to complete the aforementioned minority membership interest acquisition in Trilogy and pay down approximately $194.0 million on the Company's lines of credit.
“As a result of the accretive purchase of the part of Trilogy Holdings that we did not own, utilizing net proceeds from our recent equity offering as well as the continued improvements in our property performance, we are increasing our full year 2024 NFFO and Same-Store NOI guidance,” said Brian Peay, the Company’s Chief Financial Officer. "That same offering provided us with excess proceeds which went to pay down debt in the quarter, and that, along with the improved property performance, allowed us to improve our overall liquidity and decrease our company’s leverage profile."
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Distributions
As previously announced, the Company’s Board of Directors declared a cash distribution for the quarter ended September 30, 2024 of $0.25 per share of its common stock. The third quarter distribution was paid in cash on October 18, 2024 to stockholders of record as of September 20, 2024.
Supplemental Information
The Company has disclosed supplemental information regarding its portfolio, financial position and results of operations as of September 30, 2024 and for the quarter then ended and certain other information, which is available on the Investor Relations section of the Company's website at https://ir.americanhealthcarereit.com.
Conference Call and Webcast Information
The Company will host a webcast and conference call at 1:00 p.m. Eastern Time on November 13, 2024. During the conference call, Company executives will review third quarter 2024 results, discuss recent events and conduct a question-and-answer period.
To join via webcast, investors may use the following link: https://events.q4inc.com/attendee/458086234.
Alternatively, to join via telephone, please pre-register at the following link.
A digital replay of the call will be available on the Investor Relations section of the Company’s website at https://ir.americanhealthcarereit.com shortly after the conclusion of the call.
Forward-Looking Statements
Certain statements contained in this press release, including statements relating to the Company's expectations regarding its interest expense savings, balance sheet, net income or loss per share, FFO per share, NFFO per share, total portfolio Same-Store NOI growth, segment-level Same-Store NOI growth, occupancy, NOI growth, revenue growth, margin expansion, purchases and sales of assets, and plans for Trilogy may be considered forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Company intends for all such forward-looking statements to be covered by the applicable safe harbor provisions for forward-looking statements contained in those acts. Such forward-looking statements generally can be identified by the use of forward-looking terminology, such as “may,” “will,” “can,” “expect,” “intend,” “anticipate,” “estimate,” “believe,” “continue,” “possible,” “initiatives,” “focus,” “seek,” “objective,” “goal,” “strategy,” “plan,” “potential,” “potentially,” “preparing,” “projected,” “future,” “long-term,” “once,” “should,” “could,” “would,” “might,” “uncertainty” or other similar words. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. Any such forward-looking statements are based on current expectations, estimates and projections about the industry and markets in which the Company operates, and beliefs of, and assumptions made by, the Company's management and involve known and unknown risks and uncertainties that could cause actual results to differ materially from those expressed or implied therein, including, without limitation, risks disclosed in the Company's Annual Report on Form 10-K for the year ended December 31, 2023, and other periodic reports filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any obligation to update or revise any forward-looking statements contained in this release.

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Non-GAAP Financial Measures
The Company’s reported results are presented in accordance with GAAP. The Company also discloses the following Non-GAAP financial measures: EBITDA, Adjusted EBITDA, NAREIT FFO, NFFO, NOI and Same-Store NOI. The Company believes these Non-GAAP financial measures are useful supplemental measures of its operating performance and used by investors and analysts to compare the operating performance of the Company between periods and to other REITs or companies on a consistent basis without having to account for differences caused by unanticipated and/or incalculable items. Definitions of the Non-GAAP financial measures used herein and reconciliations to the most directly comparable financial measure calculated in accordance with GAAP can be found at the end of this earnings release. See below for further information regarding the Company's Non-GAAP financial measures.
EBITDA and Adjusted EBITDA
Management uses earnings before interest, taxes, depreciation and amortization (“EBITDA”) and Adjusted EBITDA to facilitate internal and external comparisons to our historical operating results and in making operating decisions. EBITDA and Adjusted EBITDA are widely used by investors, lenders, credit and equity analysts in the valuation, comparison, investment recommendations of companies. Additionally, EBITDA and Adjusted EBITDA are utilized by our Board of Directors to evaluate management. Neither EBITDA nor Adjusted EBITDA represents net income (loss) or cash flow provided from operating activities as determined in accordance with GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the EBITDA and Adjusted EBITDA may not be comparable to similarly entitled items reported by other REITs or other companies.
Funds from Operations (FFO) and Normalized Funds from Operations (NFFO)
We believe that the use of FFO, which excludes the impact of real estate-related depreciation and amortization and impairments, provides a further understanding of our operating performance to investors, industry analysts and our management, and when compared year over year, reflects the impact on our operations from trends in occupancy rates, rental rates, operating costs, general and administrative expenses and interest costs, which may not be immediately apparent from net income (loss). However, FFO and NFFO should not be construed to be (i) more relevant or accurate than the current GAAP methodology in calculating net income (loss) as an indicator of our operating performance, (ii) more relevant or accurate than GAAP cash flows from operations as an indicator of our liquidity or (iii) indicative of funds available to fund our cash needs, including our ability to make distributions to our stockholders. The method utilized to evaluate the value and performance of real estate under GAAP should be construed as a more relevant measure of operational performance and considered more prominently than the Non-GAAP FFO and NFFO measures and the adjustments to GAAP in calculating FFO and NFFO. Presentation of this information is intended to provide useful information to investors, industry analysts and management as they compare the operating performance metrics used by the REIT industry, although it should be noted that some REITs may use different methods of calculating funds from operations and normalized funds from operations, so comparisons with such REITs may not be meaningful.
Net Operating Income
We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are appropriate supplemental performance measures to reflect the performance of our operating assets because NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI exclude certain items that are not associated with the operations of the properties. We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are widely accepted measures of comparative operating performance in the real estate community and is useful to
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investors in understanding the profitability and operating performance of our property portfolio. However, our use of the terms NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI may not be comparable to that of other real estate companies as they may have different methodologies for computing these amounts.
NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are not equivalent to our net income (loss) as determined under GAAP and may not be a useful measure in measuring operational income or cash flows. Furthermore, NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be considered as alternatives to net income (loss) as an indication of our operating performance or as an alternative to cash flows from operations as an indication of our liquidity. NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be construed to be more relevant or accurate than the GAAP methodology in calculating net income (loss). NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should be reviewed in conjunction with other measurements as an indication of our performance.
About American Healthcare REIT, Inc.
American Healthcare REIT, Inc. is a self-managed real estate investment trust that acquires, owns and operates a diversified portfolio of clinical healthcare real estate properties, focusing primarily on senior housing, skilled nursing facilities, outpatient medical buildings and other healthcare-related facilities. Its properties are located in the United States, the United Kingdom and the Isle of Man.
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AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
As of September 30, 2024 and December 31, 2023
(In thousands, except share and per share amounts) (Unaudited)
September 30, 2024December 31, 2023
ASSETS
Real estate investments, net$3,535,943 $3,425,438 
Debt security investment, net90,144 86,935 
Cash and cash equivalents67,850 43,445 
Restricted cash48,822 47,337 
Accounts and other receivables, net203,672 185,379 
Identified intangible assets, net177,804 180,470 
Goodwill234,942 234,942 
Operating lease right-of-use assets, net173,018 227,846 
Other assets, net144,817 146,141 
Total assets$4,677,012 $4,577,933 
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY
Liabilities:
Mortgage loans payable, net$1,282,853 $1,302,396 
Lines of credit and term loan, net595,970 1,223,967 
Accounts payable and accrued liabilities269,778 242,905 
Identified intangible liabilities, net5,271 6,095 
Financing obligations39,299 41,756 
Operating lease liabilities174,213 225,502 
Security deposits, prepaid rent and other liabilities52,444 76,134 
Total liabilities2,419,828 3,118,755 
Commitments and contingencies
Redeemable noncontrolling interests220 33,843 
Equity:
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding— — 
Common Stock, $0.01 par value per share; 700,000,000 shares authorized; 152,873,586 shares issued and outstanding as of September 30, 2024 and none issued and outstanding as of December 31, 20231,518 — 
Class T common stock, par value per share; shares authorized; issued and outstanding as of and shares issued and outstanding as of December 31, 2023— 194 
Class I common stock, par value per share; shares authorized; issued and outstanding as of and shares issued and outstanding as of December 31, 2023— 467 
Additional paid-in capital3,594,917 2,548,307 
Accumulated deficit(1,386,791)(1,276,222)
Accumulated other comprehensive loss(2,153)(2,425)
Total stockholders’ equity2,207,491 1,270,321 
Noncontrolling interests49,473 155,014 
Total equity2,256,964 1,425,335 
Total liabilities, redeemable noncontrolling interests and equity$4,677,012 $4,577,933 
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AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands, except share and per share amounts) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Revenues and grant income:
Resident fees and services$476,834 $416,206 $1,386,965 $1,235,458 
Real estate revenue46,980 46,970 140,963 141,134 
Grant income— 1,064 — 7,445 
Total revenues and grant income523,814 464,240 1,527,928 1,384,037 
Expenses:
Property operating expenses417,128 374,603 1,223,321 1,117,298 
Rental expenses13,150 14,574 40,200 44,422 
General and administrative11,921 11,342 35,495 36,169 
Business acquisition expenses3,537 1,024 6,334 2,244 
Depreciation and amortization44,246 49,273 132,277 138,644 
Total expenses489,982 450,816 1,437,627 1,338,777 
Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt and derivative extinguishments)(30,395)(42,005)(97,429)(122,006)
(Loss) gain in fair value of derivative financial instruments(8,967)3,402 (2,162)8,200 
(Loss) gain on dispositions of real estate investments, net(4)31,981 2,257 29,777 
Impairment of real estate investments— (12,510)— (12,510)
Loss from unconsolidated entities(2,123)(505)(4,363)(924)
Gain on re-measurement of previously held equity interest— — — 726 
Foreign currency gain (loss)2,689 (1,704)2,345 372 
Other income, net2,138 1,755 7,107 5,952 
Total net other expense(36,662)(19,586)(92,245)(90,413)
Loss before income taxes(2,830)(6,162)(1,944)(45,153)
Income tax expense(263)(284)(1,227)(775)
Net loss(3,093)(6,446)(3,171)(45,928)
Net (income) loss attributable to noncontrolling interests(1,033)457 (2,868)1,884 
Net loss attributable to controlling interest$(4,126)$(5,989)$(6,039)$(44,044)
Net loss per share of Common Stock, Class T common stock and Class I common stock attributable to controlling interest:
Basic$(0.03)$(0.09)$(0.05)$(0.67)
Diluted$(0.03)$(0.09)$(0.05)$(0.67)
Weighted average number of shares of Common Stock, Class T common stock and Class I common stock outstanding:
Basic133,732,745 66,048,991 122,893,049 66,036,253 
Diluted133,732,745 66,048,991 122,893,049 66,036,253 
Net loss$(3,093)$(6,446)$(3,171)$(45,928)
Other comprehensive income (loss):
Foreign currency translation adjustments303 (180)272 66 
Total other comprehensive income (loss)303 (180)272 66 
Comprehensive loss(2,790)(6,626)(2,899)(45,862)
Comprehensive (income) loss attributable to noncontrolling interests(1,033)457 (2,868)1,884 
Comprehensive loss attributable to controlling interest$(3,823)$(6,169)$(5,767)$(43,978)
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AMERICAN HEALTHCARE REIT, INC.
FFO and Normalized FFO Reconciliation
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands, except share and per share amounts) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Net loss$(3,093)$(6,446)$(3,171)$(45,928)
Depreciation and amortization related to real estate — consolidated properties44,208 49,235 132,163 138,530 
Depreciation and amortization related to real estate — unconsolidated entities310 96 682 254 
Impairment of real estate investments — consolidated properties— 12,510 — 12,510 
Loss (gain) on dispositions of real estate investments, net — consolidated properties(31,981)(2,257)(29,777)
Gain on re-measurement of previously held equity interest— — — (726)
Net (income) loss attributable to noncontrolling interests(1,033)457 (2,868)1,884 
Depreciation, amortization, impairments, net gain/loss on dispositions and gain on re-measurement — noncontrolling interests (4,756)(6,061)(15,865)(19,672)
NAREIT FFO attributable to controlling interest$35,640 $17,810 $108,684 $57,075 
Business acquisition expenses$3,537 $1,024 $6,334 $2,244 
Amortization of above- and below-market leases432 3,103 1,277 12,233 
Amortization of closing costs — debt security investments82 71 238 204 
Change in deferred rent(598)1,478 (1,743)1,238 
Non-cash impact of changes to equity instruments2,630 1,579 7,330 4,244 
Capitalized interest(56)(47)(261)(127)
Loss on debt and derivative extinguishments572 345 1,852 345 
Loss (gain) in fair value of derivative financial instruments8,967 (3,402)2,162 (8,200)
Foreign currency (gain) loss(2,689)1,704 (2,345)(372)
Adjustments for unconsolidated entities(71)(106)(319)(359)
Adjustments for noncontrolling interests(758)(386)(683)(976)
Normalized FFO attributable to controlling interest$47,688 $23,173 $122,526 $67,549 
NAREIT FFO and Normalized FFO weighted average common shares outstanding — diluted134,246,574 66,163,767 123,277,819 66,151,029 
NAREIT FFO per common share attributable to controlling interest — diluted$0.27 $0.27 $0.88 $0.86 
Normalized FFO per common share attributable to controlling interest — diluted$0.36 $0.35 $1.00 $1.02 
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AMERICAN HEALTHCARE REIT, INC.
Adjusted EBITDA Reconciliation
For the Three Months Ended September 30, 2024
(In thousands) (Unaudited)
Net loss$(3,093)
Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt and derivative extinguishments)30,395 
Income tax expense263 
Depreciation and amortization (including amortization of leased assets and accretion of lease liabilities)44,742 
EBITDA$72,307 
Loss from unconsolidated entities2,123 
Straight line rent and amortization of above/below market leases(250)
Non-cash stock-based compensation expense2,630 
Business acquisition expenses3,537 
Loss on disposition of real estate investment
Foreign currency gain(2,689)
Loss in fair value of derivative financial instruments8,967 
Non-recurring one-time items384 
Adjusted EBITDA$87,013 
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AMERICAN HEALTHCARE REIT, INC.
NOI and Cash NOI Reconciliation
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Net loss$(3,093)$(6,446)$(3,171)$(45,928)
General and administrative11,921 11,342 35,495 36,169 
Business acquisition expenses3,537 1,024 6,334 2,244 
Depreciation and amortization44,246 49,273 132,277 138,644 
Interest expense30,395 42,005 97,429 122,006 
Loss (gain) in fair value of derivative financial instruments8,967 (3,402)2,162 (8,200)
Loss (gain) on dispositions of real estate investments, net(31,981)(2,257)(29,777)
Impairment of real estate investments— 12,510 — 12,510 
Loss from unconsolidated entities2,123 505 4,363 924 
Gain on re-measurement of previously held equity interest— — — (726)
Foreign currency (gain) loss(2,689)1,704 (2,345)(372)
Other income, net(2,138)(1,755)(7,107)(5,952)
Income tax expense263 284 1,227 775 
Net operating income$93,536 $75,063 $264,407 $222,317 
Grant Income— (1,064)— (7,445)
Total NOI (excluding Grant Income)$93,536 $73,999 $264,407 $214,872 
Straight line rent(682)(814)(2,562)(2,897)
Facility rental expense7,619 8,889 24,347 28,251 
Other non-cash adjustments323 3,011 1,029 12,343 
COVID subsidies— (28)— (171)
Cash NOI attributable to noncontrolling interests (1)
(268)(228)(745)(653)
Cash NOI$100,528 $84,829 $286,476 $251,745 
____________
(1)All quarters are based upon current quarter's ownership percentage.
Page | 11


AMERICAN HEALTHCARE REIT, INC.
Same-Store NOI Reconciliation
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
ISHC
NOI (excluding Grant Income)$48,399 $36,728 $135,687 $104,297 
Facility rental expense7,619 8,889 24,347 28,251 
Cash NOI (1)
$56,018 $45,617 $160,034 $132,548 
New acquisitions/dispositions/transitions (1)
(8,538)(6,087)(20,966)(17,966)
Other normalizing adjustments (1)
974 — 974 — 
Same-Store NOI (1)
$48,454 $39,530 $140,042 $114,582 
Outpatient Medical
NOI$21,066 $21,998 $63,055 $67,786 
Straight line rent(148)(309)(434)(1,029)
Other non-cash adjustments87 109 333 674 
Cash NOI (2)
$21,005 $21,798 $62,954 $67,431 
New acquisitions/dispositions/transitions(812)(77)(4,853)
Non-Core Properties(824)(819)(2,511)(2,358)
Same-Store NOI (2)
$20,183 $20,167 $60,366 $60,220 
SHOP
NOI$11,307 $4,875 $27,957 $13,863 
Other non-cash adjustments— (1)— (6)
COVID subsidies— (28)— (171)
Cash NOI attributable to noncontrolling interests (2)
(78)(42)(184)(102)
Cash NOI$11,229 $4,804 $27,773 $13,584 
New acquisitions/dispositions/transitions(2,913)447 (4,020)2,484 
Development conversion664 381 1,714 1,211 
Other normalizing adjustments133 — 233 86 
Same-Store NOI$9,113 $5,632 $25,700 $17,365 
Triple-Net Leased Properties
NOI $12,764 $10,398 $37,708 $28,926 
Straight line rent(534)(505)(2,128)(1,868)
Other non-cash adjustments236 2,903 696 11,675 
Cash NOI attributable to noncontrolling interest (2)
(190)(186)(561)(551)
Cash NOI$12,276 $12,610 $35,715 $38,182 
Debt security investment(2,453)(2,014)(6,573)(6,029)
New acquisitions/dispositions/transitions— (1,072)— (3,996)
Non-Core Properties(370)(350)(1,116)(1,054)
Same-Store NOI$9,453 $9,174 $28,026 $27,103 
Page | 12


AMERICAN HEALTHCARE REIT, INC.
Same-Store NOI Reconciliation - (Continued)
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Total
NOI (excluding Grant Income)$93,536 $73,999 $264,407 $214,872 
Straight line rent(682)(814)(2,562)(2,897)
Facility rental expense7,619 8,889 24,347 28,251 
Other non-cash adjustments323 3,011 1,029 12,343 
COVID subsidies— (28)— (171)
Cash NOI attributable to noncontrolling interests (2)
(268)(228)(745)(653)
Cash NOI (1)(2)
$100,528 $84,829 $286,476 $251,745 
Debt security investment(2,453)(2,014)(6,573)(6,029)
New acquisitions/dispositions/transitions (1)
(11,449)(7,524)(25,063)(24,331)
Development conversion664 381 1,714 1,211 
Non-Core Properties(1,194)(1,169)(3,627)(3,412)
Other normalizing adjustments (1)
1,107 — 1,207 86 
Same-Store NOI (1)(2)
$87,203 $74,503 $254,134 $219,270 
____________
(1)Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024.
(2)All quarters are based upon current quarter's ownership percentage.
Page | 13


AMERICAN HEALTHCARE REIT, INC.
Same-Store Revenue Reconciliation
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
ISHC
GAAP revenue and Grant Income$409,626 $373,355 $1,196,522 $1,104,362 
Grant Income— (1,064)— (7,445)
Cash revenue (1)
409,626 372,291 1,196,522 1,096,917 
Revenue attributable to non-Same-Store properties (1)
(136,221)(117,558)(385,860)(342,891)
Other normalizing revenue adjustments(1,236)— (1,236)— 
Same-Store revenue (1)
$272,169 $254,733 $809,426 $754,026 
Outpatient Medical
GAAP revenue$33,715 $35,688 $101,464 $109,811 
Straight line rent(148)(309)(434)(1,029)
Other non-cash adjustments(262)(216)(714)(354)
Cash revenue (2)
33,305 35,163 100,316 108,428 
Revenue attributable to non-Same-Store properties— (1,542)(155)(8,707)
Revenue attributable to Non-Core Properties(1,156)(1,193)(3,686)(3,528)
Same-Store revenue (2)
$32,149 $32,428 $96,475 $96,193 
SHOP
GAAP revenue$67,208 $43,915 $190,443 $138,541 
Cash revenue attributable to noncontrolling interests (2)
(296)(280)(863)(1,016)
Cash revenue66,912 43,635 189,580 137,525 
Revenue attributable to non-Same-Store properties(22,505)(4,531)(58,967)(20,486)
Revenue attributable to development conversion(411)(199)(1,096)(1,268)
Same-Store revenue$43,996 $38,905 $129,517 $115,771 
Triple-Net Leased Properties
GAAP revenue$13,265 $11,282 $39,499 $31,323 
Straight line rent(534)(505)(2,128)(1,868)
Other non-cash adjustments217 2,893 639 11,627 
Cash revenue attributable to noncontrolling interest (2)
(190)(186)(562)(552)
Cash revenue12,758 13,484 37,448 40,530 
Debt security investment(2,453)(2,014)(6,573)(6,029)
Revenue attributable to non-Same-Store properties— (1,367)— (4,541)
Revenue attributable to Non-Core Properties(461)(432)(1,382)(1,357)
Same-Store revenue$9,844 $9,671 $29,493 $28,603 
Page | 14


AMERICAN HEALTHCARE REIT, INC.
Same-Store Revenue Reconciliation - (Continued)
For the Three And Nine Months Ended September 30, 2024 and 2023
(In thousands) (Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Total
GAAP revenue and Grant Income$523,814 $464,240 $1,527,928 $1,384,037 
Straight line rent(682)(814)(2,562)(2,897)
Other non-cash adjustments(45)2,677 (75)11,273 
Grant Income— (1,064)— (7,445)
Cash revenue attributable to noncontrolling interests (2)
(486)(466)(1,425)(1,568)
Cash revenue (1)(2)
522,601 464,573 1,523,866 1,383,400 
Debt security investment(2,453)(2,014)(6,573)(6,029)
Revenue attributable to non-Same-Store properties (1)
(158,726)(124,998)(444,982)(376,625)
Revenue attributable to development conversion(411)(199)(1,096)(1,268)
Revenue attributable to Non-Core Properties(1,617)(1,625)(5,068)(4,885)
Other normalizing revenue adjustments(1,236)— (1,236)— 
Same-Store revenue (1)(2)
$358,158 $335,737 $1,064,911 $994,593 
____________
(1)Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024.
(2)All quarters are based upon current quarter's ownership percentage.
Page | 15


AMERICAN HEALTHCARE REIT, INC.
Earnings Guidance Reconciliation
For the Year Ending December 31, 2024
(Dollars and shares in millions, except per share amounts) (Unaudited)
Revised
Full Year 2024 Guidance
Previous
Full year 2024 Guidance
LowHighLowHigh
Net (loss) income attributable to common stockholders$7.84$11.76$(8.80)$(3.05)
Depreciation and amortization(1)
158.40158.40154.50154.50
NAREIT FFO attributable to common stockholders$166.24$170.16$147.30$151.30
Amortization of intangible liabilities(1)
$1.90$1.90$1.80$1.80
Change in deferred rent(1)
(1.70)(1.70)(1.10)(1.10)
Non-cash impact of changes to equity plan(1)(2)
9.409.409.409.40
Other adjustments(3)
6.606.60(3.20)(3.20)
Normalized FFO attributable to common stockholders$182.44$186.36$154.20$158.20
Net income (loss) per common share — diluted$0.06$0.09$(0.07)$(0.02)
NAREIT FFO per common share — diluted$1.28$1.31$1.17$1.22
Normalized FFO per common share — diluted$1.40$1.43$1.23$1.27
NAREIT FFO and Normalized FFO weighted average shares — diluted130.1130.1124.5124.5
Total Portfolio Same-Store NOI growth15.0 %17.0 %12.0 %14.0 %
Segment-Level Same-Store NOI growth
ISHC21.0 %23.0 %18.0 %20.0 %
OM(0.5 %)— %(0.5 %)— %
SHOP51.5 %53.5 %45.0 %50.0 %
Triple-Net Leased Properties2.0 %4.0 %1.0 %3.0 %
____________
(1)Amounts presented net of noncontrolling interests' share and AHR's share of unconsolidated entities.
(2)Amounts represent amortization of equity compensation and fair value adjustments to performance-based equity compensation.
(3)Includes items as noted in the Company’s definition for NFFO.


Page | 16


Definitions
Adjusted EBITDA: EBITDA excluding the impact of gain or loss from unconsolidated entities, straight line rent and amortization of above/below market leases, non-cash stock-based compensation expense, business acquisition expenses, gain or loss on sales of real estate investments, unrealized foreign currency gain or loss, change in fair value of derivative financial instruments, impairments of real estate investments, impairments of intangible assets and goodwill, and non-recurring one-time items.
Cash NOI: NOI excluding the impact of, without duplication, (1) non-cash items such as straight-line rent and the amortization of lease intangibles, (2) third-party facility rent payments and (3) other items set forth in the Cash NOI reconciliation included herein. Both Cash NOI and Same-Store NOI include ownership and other adjustments.
EBITDA: A Non-GAAP financial measure that is defined as earnings before interest, taxes, depreciation and amortization.
GAAP revenue: Revenue recognized in accordance with Generally Accepted Accounting Principles (“GAAP”), which includes straight line rent and other non-cash adjustments.
ISHC: Integrated senior health campuses include a range of senior care, including independent living, assisted living, memory care, skilled nursing services and certain ancillary businesses. Integrated senior health campuses are predominantly operated utilizing a RIDEA structure
MSA: Metropolitan statistical area; a geographic area defined by the United States Office of Management and Budget that includes a city with at least 50,000 people and the surrounding counties with economic ties. MSAs are used to group cities and counties for statistical data and population censuses.
NAREIT FFO or FFO: Funds from operations attributable to controlling interest; a Non-GAAP financial measure, consistent with the standards established by the White Paper on FFO approved by the Board of Governors of NAREIT (the “White Paper”). The White Paper defines FFO as net income (loss) computed in accordance with GAAP, excluding gains or losses from sales of certain real estate assets, gains or losses upon consolidation of a previously held equity interest, and impairment write-downs of certain real estate assets and investments, plus depreciation and amortization related to real estate, after adjustments for unconsolidated partnerships and joint ventures. While impairment charges are excluded from the calculation of FFO as described above, investors are cautioned that impairments are based on estimated future undiscounted cash flows. Adjustments for unconsolidated partnerships and joint ventures are calculated to reflect FFO.
Net Debt: Total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash related to debt.
NOI: Net operating income; a Non-GAAP financial measure that is defined as net income (loss), computed in accordance with GAAP, generated from properties before general and administrative expenses, business acquisition expenses, depreciation and amortization, interest expense, gain or loss in fair value of derivative financial instruments, gain or loss on dispositions, impairments of real estate investments, impairments of intangible assets and goodwill, income or loss from unconsolidated entities, gain on re-measurement of previously held equity interest, foreign currency gain or loss, other income or expense and income tax benefit or expense.
Non-Core Properties: Assets that have been deemed not essential to generating future economic benefit or value to our day-to-day operations and/or are projected to be sold.
Normalized FFO attributable to controlling interest or NFFO: FFO further adjusted for the following items included in the determination of GAAP net income (loss): expensed acquisition fees and costs, which we refer to as business acquisition expenses; amounts relating to changes in deferred rent and amortization of above and below-market leases (which are adjusted in order to reflect such payments from a GAAP accrual basis); the non-cash impact of changes to our equity instruments; non-cash or non-
Page | 17


recurring income or expense; the noncash effect of income tax benefits or expenses; capitalized interest; impairments of intangible assets and goodwill; amortization of closing costs on debt investments; mark-to-market adjustments included in net income (loss); gains or losses included in net income (loss) from the extinguishment or sale of debt, hedges, foreign exchange, derivatives or securities holdings where trading of such holdings is not a fundamental attribute of the business plan; and after adjustments for consolidated and unconsolidated partnerships and joint ventures, with such adjustments calculated to reflect Normalized FFO on the same basis.
Occupancy: With respect to OM, the percentage of total rentable square feet leased and occupied, including month-to-month leases, as of the date reported. With respect to all other property types, occupancy represents average quarterly operating occupancy based on the most recent quarter of available data. The Company uses unaudited, periodic financial information provided solely by tenants to calculate occupancy and has not independently verified the information. Occupancy metrics are reflected at our Pro-Rata share.
Outpatient Medical or OM: Outpatient Medical buildings.
Pro-Rata: As of September 30, 2024, we owned and/or operated eight buildings through entities of which we owned 90.0% to 98.0% of the ownership interests. Because we have a controlling interest in these entities, these entities and the properties these entities own are consolidated in our financial statements in accordance with GAAP. However, while such properties are presented in our financial statements on a consolidated basis, we are only entitled to our Pro-Rata share of the net cash flows generated by such properties. As a result, we have presented certain property information herein based on our Pro-Rata ownership interest in these entities and the properties these entities own, as of the applicable date, and not on a consolidated basis. In such instances, information is noted as being presented on a “Pro-Rata share” basis.
RevPOR: Revenue per occupied room. RevPOR is calculated as total revenue generated by occupied rooms divided by the number of occupied rooms.
RIDEA: Used to describe properties within the portfolio that utilize the RIDEA structure as described in “RIDEA structure”.
RIDEA structure: A structure permitted by the REIT Investment Diversification and Empowerment Act of 2007, pursuant to which we lease certain healthcare real estate properties to a wholly-owned taxable REIT subsidiary (“TRS”), which in turn contracts with an eligible independent contractor (“EIK”) to operate such properties for a fee. Under this structure, the EIK receives management fees, and the TRS receives revenue from the operation of the healthcare real estate properties and retains, as profit, any revenue remaining after payment of expenses (including intercompany rent paid to us and any taxes at the TRS level) necessary to operate the property. Through the RIDEA structure, in addition to receiving rental revenue from the TRS, we retain any after-tax profit from the operation of the healthcare real estate properties and benefit from any improved operational performance while bearing the risk of any decline in operating performance at the properties.
Same-Store or SS: Properties owned or consolidated the full year in both comparison years and that are not otherwise excluded. Properties are excluded from Same-Store if they are: (1) sold, classified as held for sale or properties whose operations were classified as discontinued operations in accordance with GAAP; (2) impacted by materially disruptive events, such as flood or fire for an extensive period of time; or (3) scheduled to undergo or currently undergoing major expansions/renovations or business model transitions or have transitioned business models after the start of the prior comparison period.
Same-Store NOI or SS NOI: Cash NOI for our Same-Store properties. Same-Store NOI is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. Both Cash NOI and Same-Store NOI include ownership and other adjustments.
SHOP: Senior housing operating properties.
Page | 18


Square Feet or Sq. Ft.: Net rentable square feet calculated utilizing Building Owners and Managers Association measurement standards.
Total Debt: The principal balances of the Company’s revolving credit facility, term loans and secured indebtedness as reported in the Company’s consolidated financial statements.
Trilogy: Trilogy Investors, LLC; one of our consolidated subsidiaries, in which we indirectly owned a 100% interest as of September 30, 2024.
Trilogy REIT Holdings or Trilogy Holdings: Trilogy REIT Holdings, LLC; the subsidiary that owns the interest in Trilogy.
Triple-net leased: A lease where the tenant is responsible for making rent payments, maintaining the leased property and paying property taxes and other expenses.
Page | 19
Third Quarter 2024 Supplemental EXHIBIT 99.2


 
2 Forward-Looking Statements Certain statements contained in this supplemental, filed in conjunction with the Third Quarter 2024 Earnings Press Release, including statements relating to American Healthcare REIT, Inc.’s (the ”Company”) expectations regarding its portfolio growth, interest expense savings, balance sheet, net income (loss) per share, FFO per share, NFFO per share, total portfolio SS NOI growth, segment-level Same-Store NOI growth, occupancy, NOI growth, revenue growth, and margin expansion, may be considered forward- looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Company intends for all such forward-looking statements to be covered by the applicable safe harbor provisions for forward-looking statements contained in those acts. Such forward-looking statements generally can be identified by the use of forward-looking terminology such as “may,” “will,” “can,” “expect,” “intend,” “anticipate,” “estimate,” “believe,” “continue,” “possible,” “initiatives,” “focus,” “seek,” “objective,” “goal,” “strategy,” “plan,” “potential,” “potentially,” “preparing,” “projected,” “future,” “long-term,” “once,” “should,” “could,” “would,” “might,” “uncertainty,” or other similar words. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this supplemental. Any such forward-looking statements are based on current expectations, estimates and projections about the industry and markets in which the Company operates and beliefs of, and assumptions made by, the Company's management and involve known and unknown risks and uncertainties that could cause actual results to differ materially from those expressed or implied therein, including, without limitation, risks disclosed in the Company’s periodic reports as filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any obligation to update or revise any forward-looking statements contained in this supplemental. Disclaimers


 
3 Non-GAAP Financial Measures The Company’s reported results are presented in accordance with GAAP. The Company also discloses the following non-GAAP financial measures: EBITDA, Adjusted EBITDA, NAREIT FFO, NFFO, NOI and Same-Store NOI. The Company believes these non-GAAP financial measures are useful supplemental measures of its operating performance and used by investors and analysts to compare the operating performance of the Company between periods and to other REITs or companies on a consistent basis without having to account for differences caused by unanticipated and/or incalculable items. Definitions of the non-GAAP financial measures used herein and reconciliations to the most directly comparable financial measure calculated in accordance with GAAP can be found at the end of this Supplemental. See below for further information regarding the Company's non-GAAP financial measures. EBITDA and Adjusted EBITDA Management uses earnings before interest, taxes, depreciation and amortization (“EBITDA”) and Adjusted EBITDA to facilitate internal and external comparisons to our historical operating results and in making operating decisions. EBITDA and Adjusted EBITDA are widely used by investors, lenders, credit and equity analysts in the valuation, comparison, investment recommendations of companies. Additionally, EBITDA and Adjusted EBITDA are utilized by our Board of Directors to evaluate management. Neither EBITDA nor Adjusted EBITDA represents net income (loss) or cash flow provided from operating activities as determined in accordance with GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, EBITDA and Adjusted EBITDA may not be comparable to similarly entitled items reported by other REITs or other companies. Funds from Operations (FFO) and Normalized Funds from Operations (NFFO) We believe that the use of FFO, which excludes the impact of real estate-related depreciation and amortization and impairments, provides a further understanding of our operating performance to investors, industry analysts and our management, and when compared year over year, reflects the impact on our operations from trends in occupancy rates, rental rates, operating costs, general and administrative expenses and interest costs, which may not be immediately apparent from net income (loss). However, FFO and NFFO should not be construed to be (i) more relevant or accurate than the current GAAP methodology in calculating net income (loss) as an indicator of our operating performance, (ii) more relevant or accurate than GAAP cash flows from operations as an indicator of our liquidity or (iii) indicative of funds available to fund our cash needs, including our ability to make distributions to our stockholders. The method utilized to evaluate the value and performance of real estate under GAAP should be construed as a more relevant measure of operational performance and considered more prominently than the non-GAAP FFO and NFFO measures and the adjustments to GAAP in calculating FFO and NFFO. Presentation of this information is intended to provide useful information to investors, industry analysts and management as they compare the operating performance metrics used by the REIT industry, although it should be noted that some REITs may use different methods of calculating funds from operations and normalized funds from operations, so comparisons with such REITs may not be meaningful. Net Operating Income We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are appropriate supplemental performance measures to reflect the performance of our operating assets because NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI exclude certain items that are not associated with the operations of the properties. We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are widely accepted measures of comparative operating performance in the real estate community and is useful to investors in understanding the profitability and operating performance of our property portfolio. However, our use of the terms NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI may not be comparable to that of other real estate companies as they may have different methodologies for computing these amounts. NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are not equivalent to our net income (loss) as determined under GAAP and may not be a useful measure in measuring operational income or cash flows. Furthermore, NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be considered as alternatives to net income (loss) as an indication of our operating performance or as an alternative to cash flows from operations as an indication of our liquidity. NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be construed to be more relevant or accurate than the GAAP methodology in calculating net income (loss). NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should be reviewed in conjunction with other measurements as an indication of our performance. Disclaimers


 
4 Our Properties (as of 9/30/2024) (dollars in thousands) Pro-Rata (3)(4) Consolidated (4) Number of Buildings/ Campuses Beds/Units (1) Leased % (2) Wtd Avg Lease Term (years) Annualized Cash NOI Annualized Cash NOI Integrated Senior Health Campuses (ISHC) 127 13,020 86.9% — $ 224,072 55.7% $ 224,072 55.6% Outpatient Medical (OM) 86 4,400 88.1% 5.0 84,020 20.9% 84,020 20.9% Senior Housing Operating Properties (SHOP) 83 5,448 85.2% — 44,916 11.2% 45,228 11.2% Triple-Net Leased Properties 28 2,599 100.0% 10.4 39,292 9.8% 40,052 9.9% Debt Security Investment — — — — 9,812 2.4% 9,812 2.4% Total 324 6.5 $ 402,112 100.0% $ 403,184 100.0% CONSOLIDATED ANNUALIZED CASH NOI Debt Security Investment 2.4% OM 20.9% SHOP 11.2% ISHC 55.6% Triple-Net Leased Properties 9.9% (1) Outpatient Medical represents GLA in thousands, rather than Beds/Units. (2) ISHC and SHOP occupancies are quarterly averages, while Outpatient Medical and Triple-Net Leased Properties are quarter-end spot occupancies. (3) Represents all property at Pro-Rata ownership. (4) See reconciliations in the appendix of this presentation. Annualized Cash NOI shown as current quarter Cash NOI multiplied by four. Note: Except as otherwise noted, all data herein is presented on a consolidated basis.


 
5 Integrated Senior Health Campuses (ISHC) (1) Prior quarters information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024. (2) Excludes Grant Income. (3) See reconciliations in the appendix of this presentation. (4) Controllable expenses include utilities, food, repairs and maintenance, and other operating expenses. (5) Non-Controllable expenses include property taxes and insurance. Total Portfolio (1) Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Campuses 125 125 126 126 127 — — IL/AL/MC units 5,527 5,512 5,560 5,560 5,584 5,527 5,584 SNF beds 7,405 7,380 7,433 7,431 7,436 7,405 7,436 Consolidated total beds/units 12,932 12,892 12,993 12,991 13,020 12,932 13,020 Average occupancy 86.2% 85.0% 85.6% 86.0% 86.9% 85.0% 86.2% Revenues (2)(3) $ 372,291 $ 384,963 $ 393,122 $ 393,774 $ 409,626 $ 1,096,917 $ 1,196,522 Operating expenses 326,674 334,423 342,302 340,578 353,608 964,369 1,036,488 Cash NOI (2)(3) $ 45,617 $ 50,540 $ 50,820 $ 53,196 $ 56,018 $ 132,548 $ 160,034 Cash NOI margin % 12.3% 13.1% 12.9% 13.5% 13.7% 12.1% 13.4% Maintenance Capex $ 3,731 $ 3,221 $ 3,040 $ 3,371 $ 3,769 $ 13,604 $ 10,180 Same-Store (1) Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q3 2024 vs Q3 2023 YTD 9/30/23 YTD 9/30/24 YTD 2024 vs YTD 2023 Campuses 108 108 108 108 108 108 108 Consolidated beds/units 11,074 11,127 11,113 11,114 11,143 11,074 11,143 Average occupancy 86.5% 85.0% 86.2% 86.4% 87.0% 50 bps 85.5% 86.5% 104 bps Same-Store revenues (2)(3) $ 254,733 $ 261,012 $ 268,796 $ 268,461 $ 272,169 6.8% $ 754,026 $ 809,426 7.3% Same-Store operating expenses 215,203 219,070 224,397 221,272 223,715 4.0% 639,444 669,384 4.7% Compensation 141,604 143,647 144,060 143,360 146,609 3.5% 415,470 434,029 4.5% Controllable (4) 65,468 67,459 72,400 69,978 68,573 4.7% 200,093 210,951 5.4% Non-Controllable (5) 8,131 7,964 7,937 7,934 8,533 4.9% 23,881 24,404 2.2% Same-Store NOI (2)(3) $ 39,530 $ 41,942 $ 44,399 $ 47,189 $ 48,454 22.6% $ 114,582 $ 140,042 22.2% Same-Store NOI margin % 15.5% 16.1% 16.5% 17.6% 17.8% 228 bps 15.2% 17.3% 211 bps (dollars in thousands)


 
6 ISHC Revenue per Payor and Bed Type Average Daily Rate % of Resident Days % of Revenue Q3 2023 Q3 2024 % Change Q3 2023 Q3 2024 Q3 2023 Q3 2024 Private $ 352.09 $ 382.14 8.5 % 12.3% 11.7% 13.9% 13.7% Managed Care/Insurance $ 411.77 $ 403.78 (1.9) % 0.4% 0.4% 0.5% 0.5% Medicaid $ 294.45 $ 311.02 5.6 % 24.0% 23.1% 22.9% 21.9% Hospice Medicaid $ 297.37 $ 305.21 2.6 % 3.9% 3.2% 3.7% 3.0% Medicare $ 629.39 $ 651.24 3.5 % 11.3% 11.3% 23.0% 22.5% Medicare Advantage $ 518.47 $ 528.73 2.0 % 4.3% 6.0% 7.3% 9.7% Total Skilled Nursing $ 392.66 $ 419.18 6.8 % 56.2% 55.7% 71.3% 71.3% Total Senior Housing $ 172.41 $ 182.18 5.7 % 43.8% 44.3% 24.4% 24.6% Ancillary revenue $ 13.37 $ 13.41 0.3 % 0.0% 0.0% 4.3% 4.1% Total, including ancillary revenue $ 309.59 $ 327.66 5.8 % 100.0% 100.0% 100.0% 100.0% Quality Mix 72.1% 73.7% 73.4% 75.1%


 
7 Outpatient Medical (1) See reconciliations in the appendix of this presentation. Total Portfolio Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Properties 87 85 83 83 83 — — Consolidated GLA (sq ft) 4,517 4,448 4,396 4,400 4,400 4,517 4,400 Ending occupancy 89.7% 89.2% 88.1% 88.5% 88.1% 89.7% 88.1% Revenues (1) $ 35,163 $ 32,971 $ 33,724 $ 33,287 $ 33,305 $ 108,428 $ 100,316 Operating expenses 13,365 12,070 12,740 12,322 12,300 40,997 37,362 Cash NOI (1) $ 21,798 $ 20,901 $ 20,984 $ 20,965 $ 21,005 $ 67,431 $ 62,954 Cash NOI margin % 62.0% 63.4% 62.2% 63.0% 63.1% 62.2% 62.8% Revenues per square foot $ 31.14 $ 29.65 $ 30.69 $ 30.26 $ 30.28 $ 32.01 $ 30.40 Cash NOI per square foot $ 19.30 $ 18.80 $ 19.09 $ 19.06 $ 19.10 $ 19.90 $ 19.08 Maintenance Capex $ 4,518 $ 5,121 $ 1,721 $ 3,612 $ 2,962 $ 14,390 $ 8,295 Same-Store Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q3 2024 vs Q3 2023 YTD 9/30/23 YTD 9/30/24 YTD 2024 vs YTD 2023 Properties 80 80 80 80 80 80 80 Consolidated GLA (sq ft) 4,244 4,244 4,244 4,248 4,248 4,244 4,248 Ending occupancy 90.0 % 89.2 % 88.0 % 88.5 % 88.1 % (190) bps 90.0 % 88.1 % (190) bps Same-Store revenues (1) $ 32,428 $ 31,524 $ 32,303 $ 32,023 $ 32,149 (0.9%) $ 96,193 $ 96,475 0.3% Same-Store operating expenses 12,261 11,567 12,228 11,915 11,966 (2.4%) 35,973 36,109 0.4% Same-Store NOI (1) $ 20,167 $ 19,957 $ 20,075 $ 20,108 $ 20,183 0.1% $ 60,220 $ 60,366 0.2% Same-Store NOI margin % 62.2 % 63.3 % 62.1 % 62.8 % 62.8 % 59 bps 62.6 % 62.6 % (3) bps Same-Store revenue per square foot $ 30.56 $ 29.71 $ 30.44 $ 30.15 $ 30.27 $ 30.22 $ 30.28 Same-Store NOI per square foot $ 19.01 $ 18.81 $ 18.92 $ 18.93 $ 19.00 $ 18.92 $ 18.95 (dollars and square feet in thousands, except revenues per square foot and NOI per square foot)


 
8 Outpatient Medical (as of 9/30/2024) Tenants ABR S&P Credit Rating Christus Good Shepherd Health System $ 7,659 7.8% A+ Mercy Health 4,550 4.6% A+ Prime Healthcare 4,143 4.2% B- Montefiore Medical Center 2,411 2.4% BBB- Atrius Health, Inc. 2,205 2.2% BBB Remaining Portfolio 77,761 78.8% Total $ 98,729 100.0% Square Feet % On-Campus/Adjacent 1,921 43.7% Off-Campus Affiliated 1,410 32.0% Unaffiliated 1,069 24.3% Total 4,400 100.0% OM Absorption Occupied Square Feet as of December 31, 2023 3,967 Expirations (540) Renewals 420 New leases 74 Terminations (9) Adjustment/remeasurement 11 Dispositions (45) Occupied Square Feet as of September 30, 2024 3,878 Trailing 12-months Retention 79.8% (dollars and square feet in thousands)


 
9 (1) Includes future leases signed, but not commenced. (2) The total ABR expiring in the applicable year. Expiring Leases Year # of Expiring Leases Total Sq. Ft. (1) % of GLA ABR (2) % of Total ABR Average Rent per Sq. Ft. 2024 40 147 3.8% $ 2,760 2.5% $ 18.78 2025 82 530 13.6% 14,583 13.1% 27.52 2026 46 216 5.6% 5,011 4.5% 23.20 2027 71 457 11.8% 12,616 11.3% 27.61 2028 62 510 13.1% 14,995 13.4% 29.40 Thereafter 205 2,026 52.1% 61,728 55.2% 30.47 Total 506 3,886 100.0% $ 111,693 100.0% $ 28.74 (dollars and square feet in thousands, except average rent per square foot) Outpatient Medical (as of 9/30/2024)


 
10 Senior Housing Operating Properties (SHOP) (1) See reconciliations in the appendix of this presentation. (2) Excludes COVID subsidies. (3) Controllable expenses include utilities, food, repairs and maintenance, and other operating expenses. (4) Non-Controllable expenses include property taxes and insurance. Total Portfolio Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Properties 45 51 64 64 69 — — IL/AL/MC units 3,929 4,318 5,085 5,076 5,353 3,929 5,353 SNF beds 135 135 90 95 95 135 95 Consolidated total beds/units 4,064 4,453 5,175 5,171 5,448 4,064 5,448 Average occupancy 79.3 % 80.4 % 82.5 % 84.0 % 85.2 % 77.3 % 83.9 % Revenues (1) $ 43,635 $ 48,050 $ 58,720 $ 63,948 $ 66,912 $ 137,525 $ 189,580 Operating expenses (2) 38,831 41,589 52,257 53,867 55,683 123,941 161,807 Cash NOI (1)(2) $ 4,804 $ 6,461 $ 6,463 $ 10,081 $ 11,229 $ 13,584 $ 27,773 Cash NOI margin % 11.0 % 13.4 % 11.0 % 15.8 % 16.8 % 9.9 % 14.6 % RevPOR $ 4,529 $ 4,631 $ 4,795 $ 4,934 $ 5,006 $ 4,431 $ 4,915 Maintenance Capex $ 217 $ 793 $ 789 $ 3,496 $ 4,485 $ 1,382 $ 8,770 Same-Store Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q3 2024 vs Q3 2023 YTD 9/30/23 YTD 9/30/24 YTD 2024 vs YTD 2023 Properties 41 41 41 41 41 41 41 Consolidated beds/units 3,726 3,725 3,710 3,716 3,715 3,726 3,715 Average occupancy 81.8% 84.3% 85.7% 86.8% 87.8% 600 bps 80.1% 86.8% 668 bps Same-Store revenues (1) $ 38,905 $ 40,175 $ 42,397 $ 43,124 $ 43,996 13.1% $ 115,771 $ 129,517 11.9% Same-Store operating expenses (2) 33,273 34,213 34,610 34,324 34,883 4.8% 98,406 103,817 5.5% Compensation 19,219 19,839 19,890 19,846 19,927 3.7% 56,832 59,663 5.0% Controllable (3) 11,335 11,761 11,810 11,656 12,233 7.9% 33,458 35,699 6.7% Non-Controllable (4) 2,719 2,613 2,910 2,822 2,723 0.1% 8,116 8,455 4.2% Same-Store NOI (1)(2) $ 5,632 $ 5,962 $ 7,787 $ 8,800 $ 9,113 61.8% $ 17,365 $ 25,700 48.0% Same-Store NOI margin % 14.5 % 14.8 % 18.4 % 20.4 % 20.7 % 624 bps 15.0 % 19.8 % 484 bps RevPOR $ 4,300 $ 4,307 $ 4,465 $ 4,499 $ 4,542 5.6% $ 4,353 $ 4,502 3.4% (dollars in thousands, except RevPOR, and Pro-Rata)


 
11 SHOP & ISHC Partners (as of 9/30/2024) Partner/Operator State Number of Properties/Campuses Pro-Rata Share Beds/Units Consolidated Beds/ Units Trilogy Management Services KY,IN,MI,OH,WI 129 13,203 13,203 Senior Solutions Management Group AR,MS,TX,LA,MO 19 1,562 1,595 Priority Life Care IN, MI 12 988 988 Compass Senior Living OR, WA 15 907 907 Cogir Senior Living NC,CA,UT,WA 14 902 902 Heritage Senior Living PA,VA 5 653 653 Heritage Communities NE 2 220 220 Total 196 18,435 18,468


 
12 Triple-Net Leased Properties (1) Facilities are 100% triple-net leased, operators' occupancies are one quarter in arrears and hospitals are excluded. (2) Occupancy includes properties that transitioned to SHOP provided that the date of transition was during the applicable quarter. (3) See reconciliations in the appendix of this presentation. (4) Includes currency adjustment for UK properties at current quarter GBP/USD rate of 1.28. Total Portfolio Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Properties 34 28 28 28 28 — — AL/MC beds/units 928 538 538 538 538 928 538 SNF beds 2,061 2,061 2,061 2,061 2,061 2,061 2,061 Consolidated total beds/units 2,989 2,599 2,599 2,599 2,599 2,989 2,599 Average operator occupancy (1)(2) 86.3% 87.4% 91.0% 91.7% 91.4% 86.2% 91.4% Revenues (3) $ 11,470 $ 10,726 $ 10,317 $ 10,253 $ 10,305 $ 34,501 $ 30,875 Debt security investment 2,014 2,011 2,081 2,039 — 2,453 6,029 6,573 Operating expenses 874 602 619 632 482 2,348 1,733 Cash NOI (3) $ 12,610 $ 12,135 $ 11,779 $ 11,660 $ 12,276 $ 38,182 $ 35,715 Cash NOI margin % 93.5% 95.3% 95.0% 94.9% 96.2% 94.2% 95.4% Same-Store Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q3 2024 vs Q3 2023 YTD 9/30/23 YTD 9/30/24 YTD 2024 vs YTD 2023 Properties 27 27 27 27 27 27 27 Consolidated beds/units 2,599 2,599 2,599 2,599 2,599 2,599 2,599 Average operator occupancy (1) 89.1 % 90.1 % 91.0 % 91.7 % 91.4 % 238 bps 88.8 % 91.4 % 254 bps Same-Store revenues (3) $ 9,671 $ 9,709 $ 9,859 $ 9,790 $ 9,844 1.8 % $ 28,603 $ 29,493 3.1 % Same-Store operating expenses 497 489 534 542 391 (21.3) % 1,500 1,467 (2.2) % Same-Store NOI (3) $ 9,174 $ 9,220 $ 9,325 $ 9,248 $ 9,453 3.0% $ 27,103 $ 28,026 3.4% Same-Store NOI margin % 94.9 % 95.0 % 94.6 % 94.5 % 96.0 % 117 bps 94.8 % 95.0 % 27 bps Same-Store NOI (Constant Currency) (4) $ 9,183 $ 9,253 $ 9,334 $ 9,262 $ 9,430 2.7% $ 27,192 $ 28,026 3.1 % (dollars in thousands and Pro-Rata)


 
13 Triple-Net Leased Properties Rent Payment Coverage Stratification⁽¹⁾ (1) Represents trailing twelve month coverage metrics as of June 30, 2024. Percentages are based on Pro-Rata Cash NOI for the three months ended September 30, 2024. (2) Represents combined coverage metrics for all leases within each property type and total segment. Contribution to Pro-Rata Cash NOI at each Coverage Stratification for Q3 2024 (1) Tenant EBITDAR Coverage Tenant EBITDARM Coverage Coverage Senior Housing- Leased SNFs Hospital Total Weighted Average Maturity (years) Number of Leases Senior Housing- Leased SNFs Hospital Total Weighted Average Maturity (years) Number of Leases < 0.80x — — 1.8 % 1.8 % 12.7 1 — — 1.8 % 1.8 % 12.7 1 0.80x - 0.89x — 0.1 % — 0.1 % 9.5 1 — — — — — — 0.90x - 0.99x — 2.2 % — 2.2 % 7.4 1 — — — — — — 1.00x - 1.09x 0.7 % — — 0.7 % 7.7 1 — — — — — — 1.10x - 1.19x 1.2 % — — 1.2 % 26.0 1 — — — — — — 1.20x - 1.29x — — — — — — 0.7 % — — 0.7 % 7.7 1 1.30x - 1.39x — — — — — — — — — — — — 1.40x - 1.49x — 2.2 % — 2.2 % 9.0 1 1.2 % 2.3 % — 3.5 % 14.0 3 1.50x - 1.59x — — — — — — — — — — — — 1.60x - 1.69x — — — — — — — — — — — — 1.70x - 1.79x — — — — — — — — — — — — 1.80x - 1.89x — 1.2 % — 1.2 % 6.1 1 — — — — — — 1.90x - 1.99x — — — — — — — 2.2 % — 2.2 % 9.0 1 > 2.00x — — 0.4 % 0.4 % 9.2 1 — 1.2 % 0.4 % 1.6 % 6.8 2 Total 1.9 % 5.7 % 2.2 % 9.8 % 10.4 8 1.9 % 5.7 % 2.2 % 9.8 % 10.4 8 Segment Rent Coverage (2) 1.13x 1.36x 1.25x 1.29x 1.37x 1.82x 1.46x 1.65x Tenant Occupancy 84.7 % 93.2 % N/A 91.4 % 84.7 % 93.2 % N/A 91.4 %


 
14 Revenue and Lease Expiration(1) (as of 9/30/2024) (1) Excludes ISHC and SHOP. (2) Total ABR expiring in the applicable year. Month-to-month leases are included as expirations in 2024. (3) Represents total interest income from debt security investment. ABR of Expiring Leases (2) as % of Total ABR Year OM Triple-Net Leased Properties Interest Income (3) Total 2024 $ 2,760 2.5% $ — 0.0% $ — 0.0% $ 2,760 1.7% 2025 14,583 13.1% — 0.0% 4,011 100.0% 18,594 11.4% 2026 5,011 4.5% — 0.0% — 0.0% 5,011 3.1% 2027 12,616 11.3% — 0.0% — 0.0% 12,616 7.7% 2028 14,995 13.4% — 0.0% — 0.0% 14,995 9.2% Thereafter 61,728 55.2% 47,159 100.0% — 0.0% 108,887 66.9% Total $ 111,693 100.0% $ 47,159 100.0% $ 4,011 100.0% $ 162,863 100.0% (dollars in thousands)


 
15 Debt Maturities and Principal Payments (as of 9/30/2024) (1) Debt maturing after 2028 has a weighted average maturity date of February 2053 (28 Years). (2) Interest rates reflect two in-place swap derivatives for $275 million each, which mature on January 19, 2026 with strikes at 4.41% and 3.74%. (3) Excludes variable-rate debt with interest rate swaps in place. Period Lines of Credit and Term Loan Mortgage Loans Payable Noncontrolling Interests' Share of Mortgage Loans Payable, Lines of Credit and Term Loan Combined Pro-Rata Debt % of Combined Pro-Rata Debt Weighted Average Interest Rate (2) 2024 $ — $ 33,036 $ (67) $ 32,969 1.7% 3.68 % 2025 32 303,345 (270) 303,107 16.0% 6.29 % 2026 — 159,437 (8,077) 151,360 8.0% 3.05 % 2027 550,000 56,716 — 606,716 32.0% 5.25 % 2028 46,500 139,961 — 186,461 9.8% 4.85 % Thereafter (1) — 615,207 — 615,207 32.5% 3.69 % Total $ 596,532 $ 1,307,702 $ (8,414) $ 1,895,820 100.0% Weighted Interest Rate (2) 5.49% 4.28% 2.64% 4.67% Weighted average maturity (years) 2.4 15.5 1.7 11.5 Percentage of variable-rate debt (3) 7.8% 12.6% —% 11.1% (dollars in thousands)


 
16 Year-to-Date 2024 Real Estate Acquisitions and Dispositions (1) Outpatient Medical represents Square Feet GLA in thousands. Acquisitions Reportable Segment Number of Properties/ Campuses Units/Beds Gross Purchase Price Average Cost per Unit/Bed SHOP 19 1,134 $130,639 $115 Integrated Senior Health Campuses - Lease buyouts 3 325 $45,841 $141 Dispositions Reportable Segment Number of Properties/ Campuses Units/GLA(1) Gross Proceeds SHOP 1 22 $4,500 Outpatient Medical 2 52 $11,136 (dollars and square feet in thousands)


 
17 2024 Guidance(1) (1) The Company's guidance constitutes forward-looking statements within the meaning of the federal securities laws and is based on a number of assumptions that are subject to change and many of which are outside of the Company's control. Actual results may differ materially from the Company's expectations depending on factors discussed herein and in the Company's filings with the Securities and Exchange Commission. Totals may not add due to rounding. Non-GAAP financial measures and other terms, as used in this supplemental, are also defined and further explained in the appendix. The Company is unable to provide without unreasonable effort guidance for the most comparable GAAP financial measures of total revenues and property operating and maintenance expenses. Additionally, a reconciliation of the forward-looking non-GAAP financial measures of Same-Store NOI growth to the comparable GAAP financial measures cannot be provided without unreasonable effort because the Company is unable to reasonably predict certain items contained in the GAAP measures, including non-recurring and infrequent items that are not indicative of the Company's ongoing operations. Such items include, but are not limited to, impairment on depreciated real estate assets, net gain or loss on sale of real estate assets, stock-based compensation, casualty loss, non-Same-Store revenues, and non-Same-Store operating expenses. These items are uncertain, depend on various factors, and could have a material impact on the Company's GAAP results for the guidance period. See reconciliations in the appendix of this presentation. (2) Amounts are presented net of noncontrolling interests' share and AHR's share of unconsolidated entities. (3) Amounts represent amortization of equity compensation and fair value adjustments to performance-based equity compensation. (4) Includes items as noted in the Company’s definition for NFFO. NAREIT FFO and NFFO Attributable to Common Stockholders Revised FY 2024 Total Portfolio Same-Store NOI Growth Guidance • 15.0 - 17.0% Revised 2024 Guidance FY 2024 FY 2024 - per share Low High Low High Net income attributable to common stockholders $ 7.84 $ 11.76 $ 0.06 $ 0.09 Depreciation and amortization (2) 158.40 158.40 1.22 1.22 NAREIT FFO attributable to common stockholders $ 166.24 $ 170.16 $ 1.28 $ 1.31 Amortization of other intangible liabilities (2) 1.90 1.90 0.01 0.01 Change in deferred rent (2) (1.70) (1.70) (0.01) (0.01) Non-cash impact of changes to equity plan (2)(3) 9.40 9.40 0.07 0.07 Other adjustments (4) 6.60 6.60 0.05 0.05 Normalized FFO attributable to common stockholders $ 182.44 $ 186.36 $ 1.40 $ 1.43 NAREIT FFO and Normalized FFO weighted average shares – diluted 130.1 130.1 (dollars in millions, except per share) Revised FY 2024 Segment-Level Same-Store NOI Growth Guidance • ISHC: 21.0% - 23.0% • Outpatient Medical: (0.5)% - 0.0% • SHOP: 51.5% - 53.5% • Triple-Net Leased Properties: 2.0% - 4.0%


 
18 Components of NAV(1) (1) Dollars and square feet in thousands. Dollars, square feet and beds/units are based on Company's pro-rata ownership as of September 30, 2024. (2) Cash NOI is adjusted to exclude nonrecurring items. (3) Excludes interest income from debt security investment. Segment # of Buildings/ Campuses SQ FT Total Beds/ Units Q3 2024 Cash NOI (2) Q3 2024 Ann. Cash NOI (2) ISHC 127 9,381 13,020 $ 54,729 $ 218,916 Outpatient Medical 85 4,297 20,575 82,300 SHOP - Grouped by Avg Occupancy >80% 64 3,168 3,948 11,313 45,252 60%-80% 13 952 1,115 181 724 <60% 6 351 385 (751) (3,004) Triple-Net Leased Properties (3) 28 1,424 2,599 10,013 40,052 Total 323 19,573 21,067 $ 96,060 $ 384,240 Pro-Rata Consolidated Consolidated Wtd. Avg. Rate Obligations (Outstanding principal balance as of 9/30/24) Total Total Total Mortgage Debt $ 1,299,288 $ 1,307,702 4.28% Revolving LOC 46,532 46,532 6.23% Term Loan 550,000 550,000 5.43% Total Debt $ 1,895,820 $ 1,904,234 Cash, cash equivalents and restricted cash pertaining to debt (115,721) (115,905) Net Debt $ 1,780,099 $ 1,788,329 Other tangible liabilities, net: Accounts payable and accrued liabilities 268,658 268,750 Other 49,004 49,018 Other tangible liabilities, net 317,662 317,768 Financing 39,262 39,262 Lease obligations 174,213 174,213 Net obligations $ 2,311,236 $ 2,319,572 Other Assets Debt security investment, gross $ 89,893 $ 89,893 Other tangible assets: Accounts receivable 203,661 203,672 Capital expenditures 23,674 23,681 Inventory 20,234 20,234 Other 37,157 37,186 Total other tangible assets 284,726 284,773 Sold assets/assets expected to be sold 16,548 16,548 Total other assets $ 391,167 $ 391,214 Common Shares and OP Units Outstanding Total Common Shares 152,873,586 152,873,586 Total OP units 2,285,404 2,285,404 Total Common Shares and OP Units 155,158,990 155,158,990 Management Comments: • As of September 20, 2024, the Company owns 100% of campuses managed by Trilogy Management Services within its ISHC segment. (dollars in thousands)


 
19 Third Quarter 2024 Supplemental Appendix Non-GAAP Reconciliations and Defined Terms


 
20 FFO / NFFO Reconciliation(1) (1) Totals may not add due to rounding. QTD YTD Q3 2024 Q3 2023 2024 2023 Net $ (3,093) $ (6,446) $ (3,171) $ (45,928) Depreciation and amortization related to real estate — consolidated properties 44,208 49,235 132,163 138,530 Depreciation and amortization related to real estate — unconsolidated entities 310 96 682 254 Impairment of real estate investments — consolidated properties — 12,510 — 12,510 Loss (gain) on dispositions of real estate investments, net — consolidated properties 4 (31,981) (2,257) (29,777) Gain on re-measurement of previously held equity interest — — — (726) Net (income) loss attributable to noncontrolling interests (1,033) 457 (2,868) 1,884 Depreciation, amortization, impairments, net gain/loss on dispositions and gain on re-measurement — noncontrolling interests (4,756) (6,061) (15,865) (19,672) NAREIT FFO attributable to controlling interest $ 35,640 $ 17,810 $ 108,684 $ 57,075 Business acquisition expenses 3,537 1,024 6,334 2,244 Amortization of above- and below-market leases 432 3,103 1,277 12,233 Amortization of closing costs — debt security investments 82 71 238 204 Change in deferred rent (598) 1,478 (1,743) 1,238 Non-cash impact of changes to equity instruments 2,630 1,579 7,330 4,244 Capitalized interest (56) (47) (261) (127) Loss on debt and derivative extinguishments 572 345 1,852 345 Loss (gain) in fair value of derivative financial instruments 8,967 (3,402) 2,162 (8,200) Foreign currency (gain) loss (2,689) 1,704 (2,345) (372) Adjustments for unconsolidated entities (71) (106) (319) (359) Adjustments for noncontrolling interests (758) (386) (683) (976) Normalized FFO (NFFO) attributable to controlling interest $ 47,688 $ 23,173 $ 122,526 $ 67,549 NAREIT FFO per common share attributable to controlling interest — diluted $ 0.27 $ 0.27 $ 0.88 $ 0.86 Normalized FFO per common share attributable to controlling interest — diluted $ 0.36 $ 0.35 $ 1.00 $ 1.02 Distributions paid to common stockholders $ 32,997 $ 16,599 $ 82,591 $ 59,685 NAREIT FFO and Normalized FFO weighted average common shares outstanding — diluted 134,246,574 66,163,767 123,277,819 66,151,029 (dollars in thousands, except per share)


 
21 EBITDA Reconciliation Q3 2024 Net loss $ (3,093) Adjustments: Interest expense (including amortization of deferred financing costs, debt discount/ premium and loss on debt and derivative extinguishments) 30,395 Income tax expense 263 Depreciation and amortization (including amortization of leased assets and accretion of lease liabilities) 44,742 EBITDA $ 72,307 Loss from unconsolidated entities 2,123 Straight line rent and amortization of above/below market leases (250) Non-cash stock-based compensation expense 2,630 Business acquisition expenses 3,537 Loss on disposition of real estate investment 4 Foreign currency gain (2,689) Loss in fair value of derivative financial instruments 8,967 Non-recurring one-time items 384 Adjusted EBITDA $ 87,013 (dollars in thousands)


 
22 Coverage Ratios and Net Debt Reconciliation(1) (1) The details of the Adjusted EBITDA calculation can be found on the previous page. (2) Non-cash interest expense includes amortization of loan fees and above- and below-market debt. (3) Interest Coverage ratio calculated as Adjusted EBITDA divided by Total Interest. Fixed Charges Coverage ratio calculated as Adjusted EBITDA divided by Total Fixed Charges. Q3 2024 Interest Coverage Ratios Interest Expense $ 30,395 Capitalized Interest 56 Loss on extinguishment of debt (572) Non-Cash Interest Expense(2) (2,785) Total Interest $ 27,094 Interest Coverage ratio(3) 3.2x Fixed Charges Coverage Ratios Total Interest $ 27,094 Secured Debt Principal Amortization 5,112 Total Fixed Charges $ 32,206 Fixed Charge Coverage Ratio(3) 2.7x Total debt $ 1,904,234 Cash and cash equivalents (67,850) Restricted cash related to debt (48,055) Net debt $ 1,788,329 Net Debt / Annualized Adjusted EBITDA 5.1x (dollars in thousands)


 
23 Same-Store Property Reconciliation (1) Includes two SNFs in Central Wisconsin that transitioned from the Triple-Net Leased Properties segment to SHOP on March 1, 2023 and six Michigan properties that transitioned from the Triple-Net Leased Properties segment to SHOP on November 1, 2023. (2) ISHC includes eight expansions and six campuses under development. For the Nine Months Ended 9/30/2024 Integrated Senior Health Campuses Outpatient Medical SHOP Triple-Net Leased Properties Total properties/campuses 127 83 69 28 Recent acquisition/development conversions (1) — (20) — Non-Core Properties (4) (3) — (1) Transitions (1) — — (8) — Other (2) (14) — — — Same-Store properties 108 80 41 27


 
24 Cash NOI Reconciliation (1) All quarters are based upon ownership percentage as of the most recent quarter end. Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 2023 2024 Net (loss) income $ (6,446) $ (30,959) $ (3,004) $ 2,926 $ (3,093) $ (45,928) $ (3,171) General and administrative 11,342 11,341 11,828 11,746 11,921 36,169 35,495 Business acquisition expenses 1,024 3,551 2,782 15 3,537 2,244 6,334 Depreciation and amortization 49,273 43,960 42,767 45,264 44,246 138,644 132,277 Interest expense 42,005 41,185 36,438 30,596 30,395 122,006 97,429 (Gain) loss in fair value of derivative financial instruments (3,402) 9,126 (6,417) (388) 8,967 (8,200) 2,162 (Gain) loss on dispositions of real estate investments, net (31,981) (2,695) (2,263) 2 4 (29,777) (2,257) Impairment of real estate investments 12,510 1,389 — — — 12,510 — Impairment of intangible assets and goodwill — 10,520 — — — — — Loss from unconsolidated entities 505 794 1,205 1,035 2,123 924 4,363 Gain on re-measurement of previously held equity interests — — — — — (726) — Foreign currency loss (gain) 1,704 (1,935) 426 (82) (2,689) (372) (2,345) Other income, net (1,755) (1,649) (1,863) (3,106) (2,138) (5,952) (7,107) Income tax expense (benefit) 284 (112) 278 686 263 775 1,227 Total NOI $ 75,063 $ 84,516 $ 82,177 $ 88,694 $ 93,536 $ 222,317 $ 264,407 Grant Income (1,064) (30) — — — (7,445) — Total NOI (excluding Grant Income) $ 73,999 $ 84,486 $ 82,177 $ 88,694 $ 93,536 $ 214,872 $ 264,407 Straight line rent (814) (584) (1,132) (748) (682) (2,897) (2,562) Facility rental expense 8,889 8,774 8,840 7,888 7,619 28,251 24,347 Other non-cash adjustments 3,011 (2,397) 391 315 323 12,343 1,029 COVID subsidies (28) — — — — (171) — Cash NOI attributable to noncontrolling interests(1) (228) (242) (230) (247) (268) (653) (745) Cash NOI $ 84,829 $ 90,037 $ 90,046 $ 95,902 $ 100,528 $ 251,745 $ 286,476 (dollars in thousands)


 
25 Same-Store NOI Reconciliation (1/2) Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Integrated Senior Health Campuses NOI (excluding Grant Income) $ 36,728 $ 41,766 $ 41,980 $ 45,308 $ 48,399 $ 104,297 $ 135,687 Facility rental expense 8,889 8,774 8,840 7,888 7,619 28,251 24,347 Cash NOI (1) $ 45,617 $ 50,540 $ 50,820 $ 53,196 $ 56,018 $ 132,548 $ 160,034 New acquisitions/dispositions/transitions (1) (6,087) (7,169) (6,421) (6,007) (8,538) (17,966) (20,966) Other normalizing adjustments (1) — (1,429) — — 974 — 974 Same-Store NOI (1) $ 39,530 $ 41,942 $ 44,399 $ 47,189 $ 48,454 $ 114,582 $ 140,042 Outpatient Medical NOI $ 21,998 $ 23,825 $ 20,978 $ 21,011 $ 21,066 $ 67,786 $ 63,055 Straight line rent (309) (291) (158) (128) (148) (1,029) (434) Other non-cash adjustments 109 (2,633) 164 82 87 674 333 Cash NOI (2) $ 21,798 $ 20,901 $ 20,984 $ 20,965 $ 21,005 $ 67,431 $ 62,954 New acquisitions/dispositions/transitions (812) (116) (75) (4) 2 (4,853) (77) Non-Core Properties (819) (828) (834) (853) (824) (2,358) (2,511) Same-Store NOI (2) $ 20,167 $ 19,957 $ 20,075 $ 20,108 $ 20,183 $ 60,220 $ 60,366 SHOP NOI $ 4,875 $ 6,506 $ 6,509 $ 10,141 $ 11,307 $ 13,863 $ 27,957 Other non-cash adjustments (1) 11 — — — (6) — COVID subsidies (28) — — — — (171) — Cash NOI attributable to noncontrolling interests (2) (42) (56) (46) (60) (78) (102) (184) Cash NOI $ 4,804 $ 6,461 $ 6,463 $ 10,081 $ 11,229 $ 13,584 $ 27,773 New acquisitions/dispositions/transitions 447 (1,010) 784 (1,891) (2,913) 2,484 (4,020) Development conversion 381 340 540 510 664 1,211 1,714 Other normalizing adjustments — 171 — 100 133 86 233 Same-Store NOI $ 5,632 $ 5,962 $ 7,787 $ 8,800 $ 9,113 $ 17,365 $ 25,700 (dollars in thousands) (1) Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024. (2) All quarters are based upon current quarter’s ownership percentage.


 
26 Same-Store NOI Reconciliation (2/2) Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Triple-Net Leased Properties NOI $ 10,398 $ 12,389 $ 12,710 $ 12,234 $ 12,764 $ 28,926 $ 37,708 Straight line rent (505) (293) (974) (620) (534) (1,868) (2,128) Other non-cash adjustments 2,903 225 227 233 236 11,675 696 Cash NOI attributable to noncontrolling interest (2) (186) (186) (184) (187) (190) (551) (561) Cash NOI $ 12,610 $ 12,135 $ 11,779 $ 11,660 $ 12,276 $ 38,182 $ 35,715 Debt security investment (2,014) (2,011) (2,081) (2,039) (2,453) (6,029) (6,573) New acquisitions/dispositions/transitions (1,072) (545) — — — (3,996) — Non-Core Properties (350) (359) (373) (373) (370) (1,054) (1,116) Same-Store NOI $ 9,174 $ 9,220 $ 9,325 $ 9,248 $ 9,453 $ 27,103 $ 28,026 Total NOI (excluding Grant Income) $ 73,999 $ 84,486 $ 82,177 $ 88,694 $ 93,536 $ 214,872 $ 264,407 Straight line rent (814) (584) (1,132) (748) (682) (2,897) (2,562) Facility rental expense 8,889 8,774 8,840 7,888 7,619 28,251 24,347 Other non-cash adjustments 3,011 (2,397) 391 315 323 12,343 1,029 COVID subsidies (28) — — — — (171) — Cash NOI attributable to noncontrolling interests (2) (228) (242) (230) (247) (268) (653) (745) Cash NOI (1)(2) $ 84,829 $ 90,037 $ 90,046 $ 95,902 $ 100,528 $ 251,745 $ 286,476 Debt security investment (2,014) (2,011) (2,081) (2,039) (2,453) (6,029) (6,573) New acquisitions/dispositions/transitions (1) (7,524) (8,840) (5,712) (7,902) (11,449) (24,331) (25,063) Development conversion 381 340 540 510 664 1,211 1,714 Non-Core Properties (1,169) (1,187) (1,207) (1,226) (1,194) (3,412) (3,627) Other normalizing adjustments (1) — (1,258) — 100 1,107 86 1,207 Same-Store NOI (1)(2) $ 74,503 $ 77,081 $ 81,586 $ 85,345 $ 87,203 $ 219,270 $ 254,134 (dollars in thousands) (1) Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024. (2) All quarters are based upon current quarter’s ownership percentage.


 
27 Same-Store Revenue Reconciliation (1/2) (1) Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024. (2) All quarters are based upon current quarter’s ownership percentage. Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Integrated Senior Health Campuses GAAP revenue and Grant Income $ 373,355 $ 384,993 $ 393,122 $ 393,774 $ 409,626 $ 1,104,362 $ 1,196,522 Grant Income (1,064) (30) — — — (7,445) — Cash revenue (1) $ 372,291 $ 384,963 $ 393,122 $ 393,774 $ 409,626 $ 1,096,917 $ 1,196,522 Revenue attributable to non-Same-Store properties (1) (117,558) (123,951) (124,326) (125,313) (136,221) (342,891) (385,860) Other normalizing revenue adjustments — — — — (1,236) — (1,236) Same-Store revenue (1) $ 254,733 $ 261,012 $ 268,796 $ 268,461 $ 272,169 $ 754,026 $ 809,426 Outpatient Medical GAAP revenue $ 35,688 $ 36,257 $ 34,067 $ 33,682 $ 33,715 $ 109,811 $ 101,464 Straight line rent (309) (291) (158) (128) (148) (1,029) (434) Other non-cash adjustments (216) (2,995) (185) (267) (262) (354) (714) Cash revenue (2) $ 35,163 $ 32,971 $ 33,724 $ 33,287 $ 33,305 $ 108,428 $ 100,316 Revenue attributable to non-Same-Store properties (1,542) (256) (155) — — (8,707) (155) Revenue attributable to Non-Core Properties (1,193) (1,191) (1,266) (1,264) (1,156) (3,528) (3,686) Same-Store revenue (2) $ 32,428 $ 31,524 $ 32,303 $ 32,023 $ 32,149 $ 96,193 $ 96,475 SHOP GAAP revenue $ 43,915 $ 48,321 $ 58,996 $ 64,239 $ 67,208 $ 138,541 $ 190,443 Cash revenue attributable to noncontrolling interests (2) (280) (271) (276) (291) (296) (1,016) (863) Cash revenue $ 43,635 $ 48,050 $ 58,720 $ 63,948 $ 66,912 $ 137,525 $ 189,580 Revenue attributable to non-Same-Store properties (4,531) (7,692) (16,053) (20,409) (22,505) (20,486) (58,967) Revenue attributable to development conversion (199) (183) (270) (415) (411) (1,268) (1,096) Same-Store revenue $ 38,905 $ 40,175 $ 42,397 $ 43,124 $ 43,996 $ 115,771 $ 129,517 (dollars in thousands)


 
28 Same-Store Revenue Reconciliation (2/2) Q3 2023 Q4 2023 Q1 2024 Q2 2024 Q3 2024 YTD 9/30/23 YTD 9/30/24 Triple-Net Leased Properties GAAP revenue $ 11,282 $ 13,010 $ 13,348 $ 12,886 $ 13,265 $ 31,323 $ 39,499 Straight line rent (505) (293) (974) (620) (534) (1,868) (2,128) Other non-cash adjustments 2,893 206 210 212 217 11,627 639 Cash revenue attributable to noncontrolling interest (2) (186) (186) (186) (186) (190) (552) (562) Cash revenue $ 13,484 $ 12,737 $ 12,398 $ 12,292 $ 12,758 $ 40,530 $ 37,448 Debt security investment (2,014) (2,011) (2,081) (2,039) (2,453) (6,029) (6,573) Revenue attributable to non-Same-Store properties (1,367) (572) — — — (4,541) — Revenue attributable to Non-Core Properties (432) (445) (458) (463) (461) (1,357) (1,382) Same-Store revenue $ 9,671 $ 9,709 $ 9,859 $ 9,790 $ 9,844 $ 28,603 $ 29,493 Total GAAP revenue and Grant Income $ 464,240 $ 482,581 $ 499,533 $ 504,581 $ 523,814 $ 1,384,037 $ 1,527,928 Straight line rent (814) (584) (1,132) (748) (682) (2,897) (2,562) Other non-cash adjustments 2,677 (2,789) 25 (55) (45) 11,273 (75) Grant Income (1,064) (30) — — — (7,445) — Cash revenue attributable to noncontrolling interests (2) (466) (457) (462) (477) (486) (1,568) (1,425) Cash revenue (1)(2) $ 464,573 $ 478,721 $ 497,964 $ 503,301 $ 522,601 $ 1,383,400 $ 1,523,866 Debt security investment (2,014) (2,011) (2,081) (2,039) (2,453) (6,029) (6,573) Revenue attributable to non-Same-Store properties (1) (124,998) (132,471) (140,534) (145,722) (158,726) (376,625) (444,982) Revenue attributable to development conversion (199) (183) (270) (415) (411) (1,268) (1,096) Revenue attributable to Non-Core Properties (1,625) (1,636) (1,724) (1,727) (1,617) (4,885) (5,068) Other normalizing revenue adjustments — — — — (1,236) — (1,236) Same-Store revenue (1)(2) $ 335,737 $ 342,420 $ 353,355 $ 353,398 $ 358,158 $ 994,593 $ 1,064,911 (dollars in thousands) (1) Prior quarters' information has been updated to reflect the increase in ownership to 100% in the Company's ISHC segment effective September 2024. (2) All quarters are based upon current quarter’s ownership percentage.


 
29 • Adjusted EBITDA: EBITDA excluding the impact of gain or loss from unconsolidated entities, straight line rent and amortization of above/below market leases, non-cash stock-based compensation expense, business acquisition expenses, gain or loss on sales of real estate investments, unrealized foreign currency gain or loss, change in fair value of derivative financial instruments, impairments of real estate investments, impairments of intangible assets and goodwill, and non-recurring one-time items. • Affiliated: An OM (as defined on the next page) that, as of a specified date, has 25.0% or more of its square footage occupied by at least one healthcare system. • AL: Assisted living units. • Annualized Adjusted EBITDA: Current period (shown as quarterly) EBITDA multiplied by 4. • Annualized Base Rent or ABR: Contractual base rent for the last month of the applicable period multiplied by 12. • Cash NOI: NOI excluding the impact of, without duplication, (1) non-cash items such as straight-line rent and the amortization of lease intangibles, (2) third-party facility rent payments and (3) other items set forth in the Cash NOI reconciliation included herein. Both Cash NOI and Same-Store NOI include ownership and other adjustments. • EBITDA: A non-GAAP financial measure that is defined as earnings before interest, taxes, depreciation and amortization. • EBITDAR: Earnings before interest, taxes, depreciation, amortization and facilities rent. We use unaudited, periodic financial information provided solely by tenants to calculate EBITDAR and have not independently verified the information. • EBITDAR Coverage: The ratio of EBITDAR to contractual rent for leases or interest and principal payments for loans. EBITDAR Coverage is a measure of a property’s ability to generate sufficient cash flows for the operator/borrower to pay rent and meet other obligations. • EBITDARM: Earnings before interest, taxes, depreciation, amortization, rent and management fees. We use unaudited, periodic financial information provided solely by tenants to calculate EBITDARM and have not independently verified the information. • EBITDARM Coverage: The ratio of EBITDARM to contractual rent for leases or interest and principal payments for loans. EBITDARM Coverage is a measure of a property’s ability to generate sufficient cash flows for the operator or borrower to pay rent and meet other obligations, assuming that management fees are not paid. • GAAP revenue: Revenue recognized in accordance with Generally Accepted Accounting Principles (“GAAP”), which includes straight line rent and other non-cash adjustments. • GLA: Gross leasable area. • Grant Income: Stimulus funds granted to us through various federal and state government programs, such as the CARES Act, established for eligible healthcare providers to preserve liquidity in response to lost revenues and/or increased healthcare expenses associated with the COVID-19 pandemic; such grants are not loans and, as such, are not required to be repaid, subject to certain conditions. • Hospital: Hospital properties typically will include acute care, long-term acute care, specialty and rehabilitation hospitals and generally will be leased to single tenants or operators under triple-net lease structures. • IL: Independent living units. • Integrated senior health campuses or ISHC: Integrated senior health campuses include a range of senior care, including independent living, assisted living, memory care, skilled nursing services and certain ancillary businesses. Integrated senior health campuses are predominantly operated utilizing a RIDEA structure. • Maintenance Capex: AHR-invested capital expenditures, whether routine or non-routine (including second generation tenant incentives and leasing commissions), that are not expected to generate incremental income for the Company. • MC: Memory-care units. • NAREIT FFO or FFO: Funds from operations attributable to controlling interest; a non-GAAP financial measure, consistent with the standards established by the White Paper on FFO approved by the Board of Governors of NAREIT (the “White Paper”). The White Paper defines FFO as net income (loss) computed in accordance with GAAP, excluding gains or losses from sales of certain real estate assets, gains or losses upon consolidation of a previously held equity interest, and impairment write-downs of certain real estate assets and investments, plus depreciation and amortization related to real estate, after adjustments for unconsolidated partnerships and joint ventures. While impairment charges are excluded from the calculation of FFO as described above, investors are cautioned that impairments are based on estimated future undiscounted cash flows. Adjustments for unconsolidated partnerships and joint ventures are calculated to reflect FFO. Defined Terms


 
30 • NAV: Net asset value. • Net Debt: Total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash related to debt. • NOI: Net operating income; a non-GAAP financial measure that is defined as net income (loss), computed in accordance with GAAP, generated from properties before general and administrative expenses, business acquisition expenses, depreciation and amortization, interest expense, gain or loss in fair value of derivative financial instruments, gain or loss on dispositions, impairments of real estate investments, impairments of intangible assets and goodwill, income or loss from unconsolidated entities, gain on re-measurement of previously held equity interest, foreign currency gain or loss, other income or expense and income tax benefit or expense. • NOI margin: A profitability metric that measures how efficiently a property or portfolio is operated by comparing its NOI to its revenue. Calculated by dividing NOI by revenue. • Non-Core Properties: Assets that have been deemed not essential to generating future economic benefit or value to our day-to-day operations and/or are scheduled to be sold. • Normalized FFO attributable to controlling interest or NFFO: FFO further adjusted for the following items included in the determination of GAAP net income (loss): expensed acquisition fees and costs, which we refer to as business acquisition expenses; amounts relating to changes in deferred rent and amortization of above and below-market leases (which are adjusted in order to reflect such payments from a GAAP accrual basis); the non-cash impact of changes to our equity instruments; non-cash or non- recurring income or expense; the noncash effect of income tax benefits or expenses; capitalized interest; impairments of intangible assets and goodwill; amortization of closing costs on debt investments; mark-to-market adjustments included in net income (loss); gains or losses included in net income (loss) from the extinguishment or sale of debt, hedges, foreign exchange, derivatives or securities holdings where trading of such holdings is not a fundamental attribute of the business plan; and after adjustments for consolidated and unconsolidated partnerships and joint ventures, with such adjustments calculated to reflect Normalized FFO on the same basis. • Occupancy: With respect to OM, the percentage of total rentable square feet leased and occupied, including month-to-month leases, as of the date reported. With respect to all other property types, occupancy represents average quarterly operating occupancy based on the most recent quarter of available data. The Company uses unaudited, periodic financial information provided solely by tenants to calculate occupancy and has not independently verified the information. • OM: Outpatient Medical buildings. • OP unit: Units of limited partnership interest in the Operating Partnership, which are redeemable for cash or, at our election, shares of our common stock on a one-for-one basis, subject to certain adjustments. • Operating Partnership: American Healthcare REIT Holdings, LP, a Delaware limited partnership, through which we conduct substantially all of our business and of which Continental Merger Sub, LLC, a Delaware limited liability company and our wholly-owned subsidiary, is the sole general partner. • Pro-Rata: As of September 30, 2024, we owned and/or operated eight other buildings through entities of which we owned 90.0% to 98.0% of the ownership interests. Because we have a controlling interest in these entities, these entities and the properties these entities own are consolidated in our financial statements in accordance with GAAP. However, while such properties are presented in our financial statements on a consolidated basis, we are only entitled to our Pro-Rata share of the net cash flows generated by such properties. As a result, we have presented certain property information herein based on our Pro-Rata ownership interest in these entities and the properties these entities own, as of the applicable date, and not on a consolidated basis. In such instances, information is noted as being presented on a “Pro-Rata share” basis. • Quality Mix: Total number of Medicare, Managed Care, Medicare Advantage and private days or revenue divided by the total number of actual patient days or total revenue for all payor types within Skilled Nursing and Senior Housing beds in the ISHC segment. • Retention: The ratio of total renewed square feet and month-to-month leases retained to the total square feet expiring, excluding the square feet for tenant leases terminated and leases in assets expected to be sold for the trailing 12-months. • RevPOR: Revenue per occupied room. RevPOR is calculated as total revenue generated by occupied rooms divided by the number of occupied rooms. • RIDEA: Used to describe properties within the portfolio that utilize the RIDEA structure as described in “RIDEA structure”. Defined Terms


 
31 • RIDEA structure: A structure permitted by the REIT Investment Diversification and Empowerment Act of 2007, pursuant to which we lease certain healthcare real estate properties to a wholly-owned taxable REIT subsidiary (TRS), which in turn contracts with an eligible independent contractor (EIK) to operate such properties for a fee. Under this structure, the EIK receives management fees, and the TRS receives revenue from the operation of the healthcare real estate properties and retains, as profit, any revenue remaining after payment of expenses (including intercompany rent paid to us and any taxes at the TRS level) necessary to operate the property. Through the RIDEA structure, in addition to receiving rental revenue from the TRS, we retain any after-tax profit from the operation of the healthcare real estate properties and benefit from any improved operational performance while bearing the risk of any decline in operating performance at the properties. • Same-Store or SS: Properties owned or consolidated the full year in both comparison years and that are not otherwise excluded. Properties are excluded from Same-Store if they are: (1) sold, classified as held for sale or properties whose operations were classified as discontinued operations in accordance with GAAP; (2) impacted by materially disruptive events, such as flood or fire for an extensive period of time; or (3) scheduled to undergo or currently undergoing major expansions/renovations or business model transitions or have transitioned business models after the start of the prior comparison period. • Same-Store NOI or SS NOI: Cash NOI for our Same-Store properties. Same-Store NOI is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. Both Cash NOI and Same-Store NOI include ownership and other adjustments. • Senior Housing-Leased: Senior housing facilities cater to different segments of the elderly population based upon their personal needs and include assisted living, memory care and independent living. Residents of assisted living facilities typically require limited medical care and need assistance with eating, bathing, dressing and/or medication management, and those services can be provided by staff at the facility. Resident programs offered at such facilities may include transportation, social activities and exercise and fitness programs. Our Senior Housing-Leased properties are triple-net leased. • SHOP: Senior housing operating properties. • SNFs: Skilled nursing facilities. • Square Feet or Sq. Ft.: Net rentable square feet calculated utilizing Building Owners and Managers Association measurement standards. • Total Debt: The principal balances of the Company’s revolving credit facility, term loans and secured indebtedness as reported in the Company’s consolidated financial statements. • Trilogy: Trilogy Investors, LLC; one of our consolidated subsidiaries, in which we indirectly owned a 100% interest as of September 30, 2024. • Triple-net leased: A lease where the tenant is responsible for making rent payments, maintaining the leased property and paying property taxes and other expenses. Defined Terms


 


 
v3.24.3
Cover
Nov. 12, 2024
Cover [Abstract]  
Document Type 8-K
Amendment Flag false
Document Period End Date Nov. 12, 2024
Entity Registrant Name American Healthcare REIT, Inc.
Entity Incorporation, State or Country Code MD
Entity File Number 001-41951
Entity Central Index Key 0001632970
Entity Tax Identification Number 47-2887436
Entity Address, Address Line One 18191 Von Karman Avenue
Entity Address, Address Line Two Suite 300
Entity Address, City or Town Irvine
Entity Address, State or Province CA
Entity Address, Postal Zip Code 92612
City Area Code 949
Local Phone Number 270-9200
Written Communications false
Soliciting Material false
Pre-commencement Tender Offer false
Pre-commencement Issuer Tender Offer false
Title of 12(b) Security Common Stock, $0.01 par value per share
Trading Symbol AHR
Security Exchange Name NYSE
Entity Emerging Growth Company false

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